Mr Ahmed Suleiman

: Radiographer

: RA47177

: Review Hearing

Date and Time of hearing:10:00 03/05/2017 End: 12:00 03/05/2017

: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

: Conduct and Competence Committee
: Conditions of Practice

Allegation

During the course of your employment as a Radiographer with Liverpool Heart and Chest NHS Foundation Trust

1. On 4 November 2013 you:

a. conducted a bilateral x-ray of Patient A’s knees when only a unilateral x-ray was required;

b. altered Patient A’s x-ray to present it as if it was a unilateral image.

2. - Not Found Proved at Final Hearing

3. On 23 November 2013 you x-rayed 9 patients using the wrong exposure levels

4. In respect of 9 of the x-rays referred to in paragraph 3, you were aware that you were using the wrong exposure levels.

5. As a result of your actions at paragraphs 1 and 3 you exposed your patients to unnecessarily high levels of radiation.

6. On 28 February 2014 you carried out an incorrect examination in that you x-rayed the wrong knee for Patient B.

7. Your actions at paragraph 2 were dishonest.

8. The matters described in paragraphs 1(a), 3, 5 and 6 constitute lack of competence and/or misconduct.

9. Your actions at paragraph 1(b), 2, 4 and 7 constitute misconduct.

10. By reason of that misconduct and/or lack of competence your fitness to practise is Impaired.

Finding

Preliminary matters:
Background:

1. The Registrant commenced employment as a Band 5 Radiographer at the Liverpool Heart and Chest NHS Foundation Trust (the Trust) in May 2006. He was based in the General Radiology Department.  He was responsible for in-patients and outpatients who required plain film radiology.  His role included performing chest, abdominal, pelvis, and upper and lower limb x-rays. The Registrant was subject to the Trust’s Capability Process from 2011. He was monitored throughout this time by JR, Radiology Manager. The Capability Stage Two process was completed on 23 March 2012 when the Registrant had met all of his objectives. Following further concerns, a First Formal Review was held on 16 August 2012, and on 29 January 2013, the Capability Stage Two process concluded again, and the Registrant re-commenced full participation in the Band 5 rota.

2. Incidents then occurred on 04 November 2013 and 23 November 2013 (these are the basis of particulars 1 – 5 and 7 of the allegation). The Registrant was placed on supervised practice from 16 December 2013 onwards. Another incident (the basis for particular 6 of the allegation) then occurred on 28 February 2014.

Admissions and findings of fact:

3. At the substantive hearing the Registrant admitted particulars 1, 3, 4, 5 and 6 of the allegation and these were proved. The Registrant denied particulars 2 and 7 and these two particulars of the allegation were not proved. The remaining particulars were proved.

Decisions of the Panel in November 2015 as to Statutory Grounds, Impairment:

4. The Panel concluded that the proven facts in particulars 1(a) and 6 of the allegation were insufficiently serious as to amount to misconduct but did amount to lack of competence. However the Panel concluded that the other proven facts as set out in the particulars of the allegation namely 1(b), 3, 4 and 5 were sufficiently serious as to amount to misconduct.

5. The Panel concluded that having regard to its findings as to lack of competence and misconduct, the fitness to practise of the Registrant was impaired. In its explanation of that conclusion the Panel stated “It was evident to the Panel from seeing him [the Registrant] give evidence, that his thought processes can become confused, which might well explain these incidents. His further training and efforts to remediate these identified shortcomings, whilst relevant, do not sufficiently satisfy the Panel that there is, at present, no real risk of repetition.” The Panel further determined that the need to sustain public confidence in the profession and the duty to maintain proper professional standards also required a finding of impairment to the Registrant’s fitness to practise.

The Conditions of Practice Order imposed in November 2015:

6. Having concluded that the Registrant’s fitness to practise was impaired, the Panel considered the appropriate sanction and concluded “that a Conditions of Practice Order was the realistic and appropriate remedy in accordance with paragraph 28 of the Indicative Sanctions Guidance [published by the HCPC] and would adequately protect service users and the wider public interest”. Accordingly the Panel made a Conditions of Practice Order for a period of 18 months in the following terms;     


The Registrar is directed to annotate the Register to show that for the period of 18 months the registration of Ahmed Kabir Suleiman is subject to the following Conditions of Practice

1. You must place yourself and remain under the supervision of a registered radiographer who is present in your department (“workplace supervisor”), and supply details of your workplace supervisor to the HCPC within 7 days of your commencing any employment as a registered radiographer, including locum and agency posts.  You must attend upon  that  supervisor   as required and follow their advice and recommendations.

2. You must promptly inform the HCPC of any competency procedures started by your employer or any disciplinary proceedings taken against you by your employer;

3. You must promptly inform the HCPC of any competency procedures started by your employer or any disciplinary proceedings taken against you by your employer;
You must inform the following parties that your registration is subject to these conditions:


A. any organisation  or person employing  or contracting  with you to undertake professional work;

B. any agency you are registered with or apply to be registered with (at the time of application); and


C. any prospective employer (at the time of your application).


4.  At least 28 days prior to any review of this Order you must provide  to  the  HCPC  report(s)  from   your    workplace supervisor(s) regarding your performance.

5.  You must maintain a reflective practice profile detailing every occasion when   you   have   (a)   undertaken   any   incorrect procedure or (b) exposed a service user to inappropriate levels of  radiation  and  must  provide  a  copy  of  that  profile  to  the HCPC 28 days prior to any review of this Order or confirm that there have been no such occasions.

The Decision of This Panel:

7.   This Panel has reviewed the 18 months Conditions of Practice Order made in November 2015.


HCPC Submissions:


8.     This Panel considered the submissions of Ms Brzezina for the HCPC, both on impairment and sanction. She submitted that the Registrant’s Fitness to Practice was still impaired, that an order was still necessary and that in all the circumstances a Conditions of Practice Order was the appropriate sanction. In respect of the submission made by the Registrant that the existing conditions prevented him from obtaining employment as a radiographer, she submitted that any variation in the conditions was a matter for the Panel.

9.    The Registrant gave evidence, responded to questions and made submissions. He also submitted a written statement and produced supporting documents. In summary he submitted as follows:

• That whilst he accepted that his practice was still impaired the existing Conditions of Practice Order had the effect of precluding him from obtaining employment as a radiographer.

• The supervision requirement in the Conditions of Practice Order should be altered so as to make it explicit that the supervision could be of an indirect kind.

10. This Panel heard and accepted the advice of the Legal Assessor.

11. This Panel is aware that it has all the powers that are set out in Article 30 [1] of the Health and Social Work Professions Order 2001 [The Order] and which are summarised in the letter dated 27 March 2017 addressed to the Registrant and giving notice of this hearing.

12. This Panel is aware that impairment and, if appropriate, the order, are matters for its professional judgement.  This Panel is further aware that, when exercising that judgement, it should take into account all the presently available information. The Panel has given careful consideration to the submissions of both parties, to the oral and written evidence of the Registrant and to documents that he has produced.

13. This Panel is aware that the process under Article 30 [1] of the Order is one of review and not one of appeal and that its function is to determine whether the Registrant’s fitness to practise is still impaired and, if so, whether the Conditions of Practice order under review remains the appropriate and proportionate means of public protection or should be varied or replaced by some other order.

14. This Panel is aware that the issue of an order only arises if there is a finding of current impairment of the Registrant’s fitness to practice.

Impairment:

15. This Panel has concluded that the Registrant’s fitness to practise is still currently impaired. In coming to this conclusion the Panel noted that the facts were largely the same as those that existed in November 2015. The Registrant acknowledges that his fitness to practise is still impaired. The Registrant had not addressed the deficiencies that had been then identified, as he had not obtained relevant employment and had not been able to comply with the existing Conditions of Practice Order.

Sanction:

16. Having concluded that the Registrant’s fitness to practice is still impaired, this Panel proceeded to consider what order is appropriate, proportionate and sufficient to protect the public and safeguard the public interest. This Panel took into account the principles of proportionality balancing the interests of the Registrant with the public interest.

17. This Panel has had regard to the contents of the Indicative Sanctions Policy and is aware that sanctions should be considered in ascending order of severity. This Panel is aware the purpose of sanctions is not punitive, but to protect members of the public and to safeguard the public interest. The latter objective includes maintaining standards within the profession, together with public confidence in the profession and in its regulatory processes.

18. The Panel has concluded that to take no action, thus allowing the present order to lapse, or to impose a caution order would be inappropriate, having regard to the nature and gravity of the matters found proved. Such outcomes would not sufficiently protect the public or the public interest.

19. The Panel concluded that a Conditions of Practice Order could be formulated that would adequately protect members of the public and the public interest and which would be workable, relevant and proportionate.

20. The Panel determined that a level of supervision was required but concluded that indirect supervision would be sufficient. Accordingly the Panel decided to vary the existing Conditions of Practice Order so as to make more explicit the degree of supervision which it required. The Panel hopes that by doing so it may assist the Registrant in obtaining relevant employment.

21. Accordingly a Conditions of Practice Order in the following terms will be imposed for a period of 12 months commencing at the expiration of the existing order on 04 June 2017

Order

Order:
The Registrar is directed to annotate the Register to show that for a period of 12 months commencing on 4 June 2017 the registration of Ahmed Kabir Suleiman is subject to the following Conditions of Practice:


1. At any time you are employed as a Radiographer (paid or unpaid) or are providing radiography services, you must place yourself and remain under the supervision of a workplace line manager or supervisor.  This supervision should consist of:

 
• Working at all times (but not necessarily under the direct supervision of) a registered radiographer Band 6 or above who is present in the department or on site when you are working as a radiographer.


• Meet with your supervisor to discuss clinical practice issues on a 2-weekly basis.


2. Keep a practice log of specific cases or imaging that demonstrate learning and/or enhanced patient experience, which should be made available to a subsequent reviewing panel.


3. You must supply details of your workplace supervisor to the HCPC within 7 days of your commencing any employment as a registered radiographer including locum and agency posts. You must attend upon that supervisor as required and follow his/her advice and recommendations.


4. You must promptly inform the HCPC of any competency procedures started by your employer or any disciplinary proceedings taken against you by your employer.


5. You must inform the following parties that your registration is subject to these conditions:

A. Any organisation or person employing or contracting with you to undertake professional work;
B. Any agency you are registered with or apply to be registered with (at the time of application;) and
C. Any prospective employer (at the time of your application).


6. At least 28 days prior to any review of this order you must provide to the HCPC report(s) from your workplace supervisor(s) regarding your performance.


7. You must maintain a reflective practice profile detailing every occasion when you have undertaken (a) any incorrect practice procedure or (b) exposed a service user to inappropriate levels of radiation and must provide a copy of that profile to the HCPC 28 days prior to any review of this order or confirm that there have been no such occasions.

Notes

No notes available

Hearing history

History of Hearings for Mr Ahmed Suleiman

Date Panel Hearing type Outcomes / Status
03/05/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
03/11/2015 Conduct and Competence Committee Final Hearing Conditions of Practice